Schedule A. Advance Approval of Certain Set-Asides

Line 1. Suitability test set-aside. If the requirements of section 4942(g)(2) and Regulations section 53.4942(a)-3(b) are met, a private foundation may treat an amount set aside for a specific charitable project as a qualifying distribution in the year of the set-aside rather than in the year in which the amount is actually disbursed. A set-aside under the suitability test requires advance approval. Similar rules apply to a non-functionally integrated (NFI Type III) supporting organization under Regulations section 1.509(a)-4(i)(6)(v).

Caution: Requests must be submitted before the end of the tax year in which the amount is set aside.

Contingent set-aside. If a private foundation is involved in litigation and cannot distribute assets or income because of a court order, the foundation may request approval of a set-aside of amounts held pursuant to the court order that would otherwise be distributed as qualifying distributions, known as a contingent set-aside. See Regulations section 53.4942(a)-3(b)(9). If you are requesting approval of a contingent set-aside, at the end of this form, upload a copy of the court order restricting you from distributing assets or income.

Note: A contingent set-aside is available only to a private foundation. An NFI Type III supporting organization cannot request a set-aside under Regulations section 1.509(a)-4(i)(6)(v), applying principles set forth in Regulations section 53.4942(a)-3(b)(7).

Line 1a. State the amount of the set-aside.

Line 1b. Check “Yes” if the amount set aside will be paid by the last day of your tax year after your tax year in which the litigation is terminated. If “No,” explain.

Note: If the litigation encompasses more than 1 tax year, you may seek additional contingent set-asides.

Line 2. Describe the nature and purposes of the project and the amount of the set-aside.

Line 3. Describe the amounts and dates of planned additions to the set-aside after its initial establishment, if applicable.

Line 4. Explain why the project can be better accomplished by a set-aside rather than an immediate payment of funds.

Specific projects that can be better accomplished by the use of a set-aside include, but are not limited to, projects in which relatively long-term grants or expenditures must be made in order to assure the continuity of particular charitable projects or program-related investments (as defined in section 4944(c)) or where grants are made as part of a matching-grant program. Such projects include, for example, a plan to erect a building to house the direct charitable, educational, or other similar exempt activity of the private foundation (such as a museum building in which paintings are to be hung), even though the exact location and architectural plans have not been finalized; a

plan to purchase an additional group of paintings offered for sale only as a unit that requires an expenditure of more than 1 year’s income; or a plan to fund a specific research program that is of such magnitude as to require an accumulation of funds before beginning the research, even though not all of the details of the program have been finalized.

Line 5. Describe the project, including estimated costs, sources of any future funds expected to be used to complete the project, and location of any physical facilities to be acquired or constructed as part of the project.

Line 6. Answer “Yes” if the amounts to be set aside will actually be paid within a specified period of time that ends not more than 60 months after the date of the first set-aside.

Line 6a. State the extension of time required.

Line 6b. Explain why the proposed project could not be divided into two or more projects covering periods of no more than 60 months each.

Line 7. Answer “Yes” if you are described under section 509(a)(3) as an NFI Type III supporting organization.

Line 7a. Answer “Yes” if you have obtained a written statement from each supported organization whose exempt purpose the specific project accomplishes, signed under penalty of perjury by one of their principal officers, stating that they approve the project as one that accomplishes one or more of their exempt purposes and also approve their determination that the project is one that can be better accomplished by such a set-aside than by the immediate payment of funds.

At the end of this form, upload the written statement(s). Also, include an attestation that the set-aside dollar amount is entered on the books and records of the supporting organization as a pledge or obligation to be paid at a future date or dates within 60 months of the set-aside, as required under Regulations section 1.509(a)-4(i)(6)(v)(C).

Line 7b. Provide an explanation of how you meet the responsiveness test under Regulations section 1.509(a)-4(i)(3) with respect to a supported organization whose exempt purposes are accomplished by the specific project.